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Trigger Points

The document discusses myofascial trigger points in the upper trapezius muscle that are causing headaches in a patient. Trigger points are hyperirritable knots in muscle fibers that can cause referred pain and motor dysfunction. They form due to sustained muscle contraction which reduces blood flow and sensitizes the nervous system. Treatment may include physical therapy, massage, and posture correction to address muscle tension and imbalance.

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Marlene Carstens
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18 views4 pages

Trigger Points

The document discusses myofascial trigger points in the upper trapezius muscle that are causing headaches in a patient. Trigger points are hyperirritable knots in muscle fibers that can cause referred pain and motor dysfunction. They form due to sustained muscle contraction which reduces blood flow and sensitizes the nervous system. Treatment may include physical therapy, massage, and posture correction to address muscle tension and imbalance.

Uploaded by

Marlene Carstens
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Chanteze and Marlene

2) Myofascial Trigger Points: These hyperirritable knots or tense bands in the muscle fibers
are known as trigger points. A myofascial trigger point is a hyperirritable area that is
uncomfortable upon compression and can cause referred pain, motor dysfunction, and
autonomic abnormalities. It often exists inside a taut band of skeletal muscle. Noninvasive
techniques including spray and stretch, transcutaneous electrical stimulation, physical
therapy, and massage can all be used to treat trigger points. Invasive therapies for myofascial
trigger points include dry needling, corticosteroid or botulinum toxin injections, and local
anesthetic injections (Elizabeth Demers Lavelle , William Lavelle, Howard S Smith, 2007).
In this instance, trigger points in the upper trapezius muscle are presumably present. These
trigger sites have the potential to generate localized muscular discomfort as well as pain
referral to several regions, including the left occiput and temporal region
Increased Muscle Tension and Spasm: Complaints of upper trapezius muscular pain, stiffness,
and tightness. Acute or chronic neck-shoulder pain is a defining feature. Trigger points can
cause the upper trapezius muscle to become more tense and spasmodic. This may cause
discomfort and soreness in the referred as well as the trapezius muscles (Stretching and
Massage Does NOT Get Rid of Upper Trap Pain).
Referred Pain: Referred pain is when a person experiences pain that is not at the real site of
the problem. The upper trapezius muscles can refer discomfort to the side, top, or base of the
neck, the lower jaw, or the side of the head, which can result in headache pain. In this
instance, the upper trapezius trigger points are directing pain to the patient's left occiput and
temporal region, resulting in headaches.
Muscle Imbalance: Both trigger points and persistent muscle stress can cause muscular
imbalance. This can cause discomfort and headaches because it may alter how the shoulder
and neck move and are aligned in the upper trapezius.
Irritation of the cervical spine and nerves: Prolonged muscle tension and upper trapezius
trigger points can also impose pressure on the cervical spine and aggravate the neck-region
nerves. Headaches and discomfort in the occiput and temporal region may result from this
inflammation.
Postural Issues: The patient may spend a lot of time sitting down and using a computer during
his or her job as an administrator, which can lead to poor posture. The upper trapezius might
become more tense and produce trigger points as a result of poor posture.
Muscle Contraction and Ischemia: Trigger points (like the trigger points in the patient’s upper
trapezius) are associated with sustained contraction of muscles. This can lead to reduced
blood flow (ischemia) to the affected muscle fibers. Ischemia can cause buildup of metabolic
waste products and increased pain at the trigger point site. (3)
Nervous System Sensitization: When trigger points are present it can sensitize the nervous
system. This causes the nervous system to be more responsive to pain signals which leads to
increased pain perception and discomfort in response to various stimuli. (4)
Autonomic Nervous System Involvement: Pain and chronic muscle tension can activate the
sympathetic branch of the autonomic nervous system. The sympathetic branch activated the
bodies flight or fight response. This leads to symptoms like increased heart rate, sweating and
stress. (4)

Neuromuscular Junction Activity: In normal conditions motor neurons communicate with


muscle fibers but when trigger points are present, like in the upper trapezius, it can disrupt
normal neuromuscular junction activity. The excessive muscle contraction caused by trigger
points can lead to altered signaling at these junctions. This could potentially contribute to the
muscle dysfunction.(5)
Acetylcholine and Muscle Contraction: Acetylcholine release at the neuromuscular junction
is essential for muscle contraction. Trigger points cause abnormal acetylcholine release
pattern which leads to sustained muscle contractions and development of taut muscle bands.
(6)
A complete physical examination and assessment by a healthcare professional, such as a
physical therapist, chiropractor, or physician, would be required to treat the patient's
complaints in order to identify the precise physiological and anatomical problems involved.
Physical therapy, manual therapy, massage, stretching exercises, posture correction, and
maybe pain medication are all possible forms of treatment.
1. Admin. (2022, January 1). Stretching and massage does NOT get rid of upper trap

pain - Functional performance physical therapy. Functional Performance Physical

Therapy. https://fpphysicaltherapy.com/upper-trap-neck-pain-treatment-prevention/

2. Lavelle, E. D., Lavelle, W. F., & Smith, H. S. (2007b). Myofascial trigger points.

Anesthesiology Clinics, 25(4), 841–851. https://doi.org/10.1016/j.anclin.2007.07.003

3. Esparza, D., Aladro-Gonzalvo, A. R., & Rybarczyk, Y. (2019). Effects of Local

Ischemic Compression on Upper Limb Latent Myofascial Trigger Points: A Study of

Subjective Pain and Linear Motor Performance. Rehabilitation Research and

Practice, 2019, 1–8. https://doi.org/10.1155/2019/5360924

4. Compression of Myofascial Trigger Points Alters Brain and Nervous System Activity.

(2017, December 5). MASSAGE Magazine.

https://www.massagemag.com/myofascial-trigger-points-nervous-system-87582/

5. Gerwin, R. D. (2023). A New Unified Theory of Trigger Point Formation: Failure of

Pre- and Post-Synaptic Feedback Control Mechanisms. International Journal of

Molecular Sciences, 24(9), 8142. https://doi.org/10.3390/ijms24098142

6. ‌Jafri, M. S. (2014). Mechanisms of Myofascial Pain. International Scholarly

Research Notices, 2014, 1–16. https://doi.org/10.1155/2014/523924

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